Business SessionBrian Paradis

Des Cummings

Eddie Soler

Agenda

• 2009 Strategic Overview

• Market & Competitive Assessment

• Stewardship & Resource Management

• Operational Performance

Where we are going

If you don’t know where you’re going, any road will do.

country song-paraphrased

PPM’s DraftExcellence Element

MissionTo extend the

Healing Ministry of

Christ

VisionTo become a

global pacesetter delivering

preeminent, faith-based health care

ValuesIntegrity

CompassionBalance

ExcellenceStewardship

Team

TEAMEngage employees

and physicians around mission, vision and values

SERVICEEnrich our patient’s

experience

MARKETExpand the market

and extend our patient’s

continuum of care

FINANCEIncrease efficiency

and be faithful stewards of resources

CLINICALElevate our

patient safety and clinical

excellence

Surgical Market Share 50.0% 51.0% 53.0% 54.5%Brand Preference (TBD)OP Revenue (TBD)Health Status of Community (TBD)

Mortality 1.27 1.23% 1.20% 1.17%Events with Harm 95 85 80 70Infections (TBD)Readmissions 9.90% 9.95% 9.00% 8.50%

HCAHPS – Inpatient 61% 66% 69% 72%ED SatisfactionOutpatient (TBD)Patient Experience/Mission Extension (TBD)

Cash to Long Term Debt 115% 125% 140% 150%Operating Cost per Admit 1,415 1,415 1,415 1,415

Key Performance Metric ’09 ‘10 ’11 ’12 ResponsibilityGoal Statement

Engage and retain

employees and physicians

Monitor and respond to customer needs and concerns

Be one of the safest

hospitals in the country

Increase market share

Support our mission,

vision and values

RN Retention (TBD)

Employee Engagement 70th% 72th% 74th% 75th% Safety Survey (TBD)Creation Health/Employee Health Status (TBD)*Medical Staff (TBD)

*TBD = To be determined

80th%

75%70%

1.14%60

8.00%

55%

150%1,415

GOAL

Critical Concept #1

Caring for the whole person requires balanced performance

• Two greater among equals– Safety (Accreditation)

– Cash (Security, Do Stuff)

Critical Concept #2

• Mission Driven

• Market Responsive (Quality & Experience)

• Money Disciplined

SIA to 09 Priorities

Strategic Innovation Agenda

2009 System Priorities

Business Units/Campus Plan

Your Department Plan

Strategic Innovation Agenda

• ELEVATE PATIENT SAFETY and CLINICAL EXCELLENCE

• “EXCELERATE” CORE PROCESS IMPROVEMENT

• ENRICH our PATIENTS’ EXPERIENCE

• Extend our Care Continuum

• Engage our Community

2009 System Priorities

• Grow the Market• Develop New and Strengthen Existing Markets

• REPOSITION SURGICAL CAPABILITY for GROWTH

• Develop and Implement an Aligned Ambulatory Model

• Grow Philanthropy

• Improve Revenue Share

• Manage Florida as a Market

2009 System Priorities

• Improve the Product• Patient Safety / Clinical Excellence• Performance Improvement Functions • Critical Process and Performance Focus• Deploy and Leverage Cerner • PATIENT EXPERIENCE• Disney Children’s Hospital Launch• Strengthen and Support Medical Education and

Research• Stewardship and Resource Management

Market & Competitive Assessment

Des Cummings

Macro-EnvironmentMacro-Environment

• Economic Trauma Economic Trauma

• Uninsured/Government pressureUninsured/Government pressure

• Market Growth/Utilization Market Growth/Utilization

• Competitive ChallengesCompetitive Challenges

• National Health Care ReformNational Health Care Reform

Labor MarketLabor Market

Source: Florida Research and Economic Database

Tri-County Unemployment Statistics

6.0%

4.1%

6.5%

4.6%

5.7%

3.8%

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

7.0%

2007 July

2008 July

Orange

Osceola

Seminole

Economic Trauma Economic Trauma Facing FamiliesFacing Families

• Postponed getting needed health care -- 29%Postponed getting needed health care -- 29%

• Skipped a recommended test – 24%Skipped a recommended test – 24%

• Did not filled a prescription – 23%Did not filled a prescription – 23%

• Cut pills in half or skipped doses – 19%Cut pills in half or skipped doses – 19%

• Kaiser Public Opinion Survey, Survey Brief #7773, April Kaiser Public Opinion Survey, Survey Brief #7773, April

20082008

• N = 2,003N = 2,003

Orlando Area Orlando Area Uninsured PopulationUninsured Population

Source: U.S. Census Bureau and Solucient

Florida

2006 18.8%

2005 17.9%

2003 15.4%

2007 19.4%

174,052

179,063

185,554188,462

194,632

201,444

209,300

194,632

199,498

204,485

150,000

160,000

170,000

180,000

190,000

200,000

210,000

220,000

2003 2004 2005 2006 2007A 2008E 2009E

+3.3%

+1.6%

+3.6%

+2.9%

+3.5%

+3.9%

Source: AHCA, Tri County Patients, All DRGs excluding 390, 391 and 462, 2007 annualized using Q1– Q32008E & 2009E projections based on Solucient population and growth rates

Inpatient Market Inpatient Market Discharge GrowthDischarge Growth

Population-DrivenGrowth

Utilization-Driven Growth

}

• Population growth is expected to grow IP discharges by 2.5% annually• Utilization growth is expected to grow IP discharges an additional 1.0% in 2008E and 1.4% in 2009

Competitive ChallengesCompetitive Challenges

• Arnold Palmer Hospital for ChildrenArnold Palmer Hospital for Children -- $56 million -- $56 million renovation, increasing pediatric bed size from 96 to 158, in renovation, increasing pediatric bed size from 96 to 158, in June 2009. June 2009.

• Dr. P. Phillips HospitalDr. P. Phillips Hospital -- $175 million renovation project, -- $175 million renovation project, increasing bed size from 135 to 240 beds, in 2010. increasing bed size from 135 to 240 beds, in 2010.

• South Lake HospitalSouth Lake Hospital -- 54 of the 196 new beds in 2010. By -- 54 of the 196 new beds in 2010. By 2016, will have a total of 300 beds and 350,000 square-feet.2016, will have a total of 300 beds and 350,000 square-feet.

40%

Combined Attributes

Combined Attributes are: Best Doctors, Best Nurses, Best Overall Quality, and Best Image / Reputation

GAP

9.8 12.4 8.7 12.6 6.2

BASE SIZE 719 1,148 1,264 1,095 1,110

Source: National Research Corporation, Tri-County Respondents

Consumer Consumer PreferencePreference

45.1%48.6%47.9%

50.2%47.9%

38.9%36.0%

39.2%37.8%38.1%

0%

10%

20%

30%

50%

60%

2004 2005 2006 2007 2008

FHOH

14%

19%

36%

48%

47%

56%

60%

76%

13%

20%

38%

50%

55%

60%

71%

81%

ReligiousAffliliation

Academic/ResearchFacility

Family/FriendsRecommendation

Patient SatisfactionReport Card

ConvenientLocation

Clinical QualityReport Card

DoctorRecommends

InsuranceCoverage

2008

2007

Source: Orlando MSA; NRC 2007-2008

If you had to go to a hospital for a planned overnight stay, If you had to go to a hospital for a planned overnight stay, how important would the following factors be to you when how important would the following factors be to you when selecting a hospital? (% rating “Very Important”)selecting a hospital? (% rating “Very Important”)

(n=1,403)

34.3% 34.7% 35.0%36.1% 36.5%

47.2%47.7%48.9%48.8%49.3%

20%

25%

30%

35%

40%

45%

50%

55%

2004 2005 2006 2007 2008A

FH OH

2004 2005 2006 2007 2008A210,697 216,850 220,521 227,712 234,760

Total Admissions

GAP +15.0 +14.1 +13.9 +11.6 +10.7

IP Market ShareIP Market ShareTri-County HospitalsTri-County Hospitals(regardless of patient origin)(regardless of patient origin)

Source: Local Health Council – All Admissions, regardless of patient origin; Gap is based on difference between FH and OH, 2008 annualized using Q1 & Q2* Including Lakeside, the IP market grew +3.3% from 2007 to 2008A

Market FH OH

‘04 – ’05 2.9% 1.9% 4.0%

’05 – ’06 1.7% 1.8% 2.7%

’06 – ’07 3.3% 0.8% 6.5%

’07 – ’08A 3.1% 1.9% 4.2%

27.9% 27.8% 27.5%

30.2%31.8%

45.1%45.7%47.1%46.6%46.2%

20%

25%

30%

35%

40%

45%

50%

2004 2005 2006 2007 2008A

FH OH

2004 2005 2006 2007 2008A634,394 686,214 691,396 715,683 756,480Total ED Visits

GAP +18.2 +18.8 +19.3 +15.5 +13.3

Source: Local Health Council – All ED Visits, regardless of patient origin; Gap is based on difference between FH and OH

ED Visit Market ShareED Visit Market ShareTri-County HospitalsTri-County Hospitals(regardless of patient origin)(regardless of patient origin)

Market FH OH

‘04 – ’05 8.2% 9.2% 7.6%

’05 – ’06 0.8% 1.8% -0.3%

’06 – ’07 3.5% 0.4% 13.6%

’07 – ’08A 5.7% 4.2% 10.6%

StrategiesStrategies

• Planning projections have higher degree of uncertaintyPlanning projections have higher degree of uncertainty • Contingency Plans & Focused TrackingContingency Plans & Focused Tracking

• Grow Market Share – Centennial VisionGrow Market Share – Centennial Vision• Patient ExperiencePatient Experience• Ginsburg Tower – Managing Florida as a marketGinsburg Tower – Managing Florida as a market

• Cardio VascularCardio Vascular• Attack CentersAttack Centers• TransplantTransplant

• Surgery Surgery • ED – Service Promise & Attack CentersED – Service Promise & Attack Centers• RadiologyRadiology• CancerCancer

Stewardship and Resource Management

Eddie Soler

Admissions by Service Type

2007

Sept YTD

2008

Sept YTD Variance % Change

Acute 67,512 71,078 3,566 5.28%

Psych 2,664 1,771 (893) -33.52%

Rehab 480 535 55 11.46%

OB 7,141 6,318 (823) -11.52%

Peds 3,807 3,622 (185) -4.86%

Total 81,604 83,324 1,720 2.11%

Admissions by Campus

2008

Annualized

2009

Budget Variance % Change

Orlando 44,229 46,107 1,878 4.25%

Altamonte 18,251 19,091 840 4.60%

Apopka 3,255 3,299 44 1.36%

East 15,472 16,082 610 3.94%

Winter Park 15,569 15,841 272 1.74%

Kissimmee 4,095 4,075 (20) -0.48%

Celebration 10,228 10,783 555 5.43%

Total 111,099 115,278 4,179 3.76%

* Annualized data corresponds to September YTD

Net ED Visits by Campus

2008

Annualized

2009

Budget Variance % Change

Orlando 55,863 59,938 4,075 7.30%

Altamonte 53,399 55,250 1,851 3.47%

Apopka 31,316 33,078 1,762 5.63%

East 64,716 65,725 1,009 1.56%

Winter Park 36,539 38,635 2,096 5.74%

Kissimmee 33,860 36,562 2,702 7.98%

Celebration 53,051 56,329 3,278 6.18%

Total 328,743 345,517 16,774 5.10%

* Annualized data corresponds to September YTD

Total Surgeries by Campus

2008

Annualized

2009

Budget Variance % Change

Orlando 27,839 28,993 1,154 4.15%

Altamonte 8,931 8,679 (252) -2.82%

East 3,899 4,007 108 2.78%

Winter Park 8,715 8,222 (493) -5.65%

Kissimmee 1,759 1,996 237 13.50%

Celebration 6,077 6,090 13 0.21%

Total 57,219 57,987 768 1.34%

* Annualized data corresponds to September YTD

EBDIT GAP

Preliminary Current Variance

Track I - Improvement 20,000,000 20,000,000 0

Track II - Improvement 50,000,000 46,221,488 (3,778,512)

Operational Set-asides (15,261,999) (20,734,791) (5,472,792)

Strategic Initiatives (10,000,000) (17,429,328) (7,429,328)

Total 44,738,001 28,057,369 (16,680,632)

Initiatives

2008 2009

Grow the Market 3,350,000 11,375,900

Safety 5,078,102 13,242,530

Investment in Team 1,690,000 5,391,667

Patient Experience 0 6,228,000

I-Extend Investment 9,269,486 9,667,148

Total Initiatives 19,387,588 45,905,245

Operational PerformanceBrian Paradis

Team

2005 2006 2007 YTD 08 Goal

Engagement 3.97 4.00 4.00 4.10 4.07

RN Separation (R12) 17.2% 18.7% 16.7% 16.6% 15.00%

RN Hires 698 687 635 768 626

Overtime 441 420 446 398 371

Travelers 220 147 165 26 N/A

Trends

Clinical - Core Process

YTD 08 Bud. Var.

Door to Departure 454 390 64 min

Door to Departure (%met goal) 55.1% 66.6% -11.5%

Door to Doctor 73 60 13 min

OR 1st Case Starts 70.4% 75.0% -4.6%

Rad TAT - CT w/ Contrast

(% met goal)

TBD TBD TBD

Avg. Blood Glucose TBD TBD TBD

Vent Resp. Indicators TBD TBD TBD

Pharmacy TAT TBD TBD TBD

Medication Reconciliation TBD TBD TBD

Service Performance

YTD

2005 2006 2007 2008 Goal

IP Satisfaction 57% 55% 54% 54% 65%

HCAHPS N/A N/A 56% 53% N/A

ED Satisfaction 44% 43% 45% 53% 53%

Closing